LATEST HESI Mental Health EXAM 2024

Which is the usual age of onset for cyclothymic disorders? a. Childhood b. Adolescence c. Middle adulthood d. Late adulthood b. Adolescence Cyclothymic disorders usually begin in adolescence or early adulthood. They typically begin later than childhood but earlier than middle or late adulthood. A nurse is caring for a patient with severe depression. After 4 months of treatment, the nurse tells the patient, "Depression is an illness that is beyond a person ' s voluntary control." In which phase of treatment is this an appropriate statement by the nurse? a. Acute phase b. Orientation phase c. Continuation phase d. Maintenance phase c. Continuation phase There are three phases of treatment for depression: the acute phase, the continuation phase, and the maintenance phase. After 4 to 9 months of treatment, patients are in the continuation phase, during which they are educated about depression in hopes that they will better adhere to the treatment plan and avoid relapse. Explaining depression is beyond a person's control is an example of this teaching. The other stages of treatment have different goals, such as the acute phase (the initial 12 weeks) in which the patient is given interventions to simply reduce symptoms of depression. The orientation phase is not one of the three phases of the treatment. After 1 year of treatment, patients are typically in the maintenance phase, where they may already be well educated about depression and the treatment focuses on avoiding further complications from relapse of the illness. Which is the recommended starting dose of selective serotonin reuptake inhibitors in older adult patients with depression? a. The lowest adult dose b. The normal adult dose c. Half the lowest adult dose d. Half the normal adult dose c. Half the lowest adult dose Older adult patients with depression are frequently prescribed selective serotonin reuptake inhibitors as a first-line treatment. They must be administered half the lowest adult dose to avoid adverse effects from drug accumulation. The lowest adult dose, normal adult dose, and half the normal adult should not be administered to older adult patients. These doses would cause severe toxic effects in older adult patients. A nurse is performing an assessment of a child diagnosed with disinhibited social engagement disorder. Which behavior would the nurse expect to find in the child? a. The child throws stones at strangers. b. The child willingly goes with a stranger. c. The child cries when touched by a stranger. d. The child hides when a stranger approaches. b. The child willingly goes with a stranger. Disinhibited social engagement disorder is characterized by absence of normal fear toward strangers and unresponsiveness to separation from a caregiver. The child demonstrates no normal fear of strangers. A child throwing stones at a stranger is indicative of antisocial behavior. A child crying when being touched by a stranger demonstrates sensitive behavior. A child hiding when approached by a stranger reflects shyness and is not a symptom of disinhibited social engagement disorder. Which nursing intervention is an appropriate response to anosognosia in a patient with schizophrenia experiencing psychosis? a. Establish trust and rapport. b. Convey empathy and support. c. Reduce excessive stimulation. d. Explain the diagnosis in a confident manner. a. Establish trust and rapport. Anosognosia is common in patients with severe mental illness and is not denial or resistance to accepting the diagnosis. The patient cannot recognize they have an illness. It is important for the nurse to establish trust and rapport with the patient, because this will allow the nurse to provide treatment and implement interventions to help the patient remain safe and gain awareness of their illness. Empathy and support are not helpful if the patient does not recognize that they are ill. Reducing excessive stimulation is an intervention for a patient who is restless or agitated. Explaining the diagnosis in a confident manner will not promote the patient‘s awareness of their illness. Which nursing intervention is appropriate to include in the care plan for a patient with psychosis experiencing poor self-esteem? a. Introduce pet therapy. b. Seek areas of commonality. c. Engage regularly with the patient. d. Involve the patient in planning treatment. c. Engage regularly with the patient. Engaging regularly with a patient with poor self-esteem is important in establishing a trusting nurse-patient relationship. Pet therapy may help patients who avoid interaction with peers increase their comfort level with other people. Seeking areas of commonality is beneficial when a patient is experiencing denial, such as in the case of anosognosia. Involving the patient in planning treatment is beneficial when the patient is nonadherent or resistant to treatment. Which action is included in the nursing plan of care for a patient diagnosed with panic- level anxiety who is exhibiting severe hyperactivity? a. Place the patient in seclusion. b. Attend to the patient‘s physical needs. c. Help the patient identify the source of anxiety. d. Communicate using simple, loud, clear statements. b. Attend to the patient‘s physical needs. The nursing care plan for a patient diagnosed with anxiety who is exhibiting severe hyperactivity is to attend to the patient‘s physical needs. Severe hyperactivity is characteristic of a panic level of anxiety and attending to physical needs such as elimination, fluids, and nutrition are important. Seclusion should only be initiated after all other interventions have been tried and are unsuccessful. Helping a patient identify the source of anxiety is more effective for a patient experiencing mild to moderate anxiety. When the nurse is communicating with a patient experiencing severe anxiety, a low- pitched voice should be used. Which defense mechanism has an adaptive use? a. Splitting b. Undoing c. Projection d. Conversion b. Undoing Undoing is a defense mechanism with an adaptive use. Splitting and conversion do not have adaptive uses and are almost always pathological. Projection is a defense mechanism that is considered immature and does not have an adaptive use. A client frantically reports to the nurse that "You have got to help me! Something terrible is happening. I can't think. My heart is pounding, and my head is throbbing." The nurse should assess the client at what level of anxiety? a. mild b. panic c. moderate d. severe d. severe Severe anxiety is characterized by feelings of falling apart and impending doom, impaired cognition, and severe somatic symptoms such as headache and pounding heart. Mild anxiety involves a heightened perceptual field. In the panic state, the individual is unable to attend to the environment, and focus is lost. With moderate anxiety, the person grasps less of what is going on. The nurse anticipates that the nursing history of a client diagnosed with obsessive compulsive disorder (OCD) will reveal what common assessment data? (Select all that apply.) a. An eating disorder b. A previous suicide attempt c. A history of sexual abuse d. A history of childhood trauma e. A sibling with the disorder a. An eating disorder c. A history of sexual abuse d. A history of childhood trauma e. A sibling with the disorder Sexual and physical abuse in childhood or trauma increases the risk of this disorder. Genetics are strongly associated with this disorder. First-degree relatives have twice the risk. OCD tends to occur along with anxiety disorders 76% of the time. Other comorbid conditions include major depressive disorder, bipolar disorder, and eating disorders.